Openaccesspeer-reviewedchapterTimeandModeofDeliveryinTwinPregnanciesByEduardoFélixMartinsSantana,VivianMeloCorrêa,IsabelaBotturaandJoséPedroPariseFilhoSubmitted:March21st2018Reviewed:July10th2018Published:December31st2018DOI:10.5772/intechopen.80092Home>Books>MultiplePregnancy-NewChallengesAdvertisementDownloaded:1224AdvertisementAbstractTherearemanysuitablerecommendationsfortwingestationtermintheliterature.Inmanyprotocols,resolutionisrecommendedfordichorionicpregnanciesaround38 weeks,at36 weeksformonochorionic(devoidofcomplications)andat32–34 weeksincasesofsingleamnioticchamber.Themainriskassociatedwithvaginaldeliveryisconnectedtothepossibilityofanoxiaofthesecondtwin.However,acesareandeliveryperformedbynon-cephalicpresentationofthesecondtwinisassociatedwithincreasedmaternalmorbiditywithoutimprovedneonataloutcome.Themostimportantfactorsinthedecisionofthedeliverymodeincludethepresentationofthefetus,gestationalage,andweightortheweightdifferencebetweenthefetuses.KeywordstwinpregnancydeliverylaborchapterandauthorinfoAuthorsEduardoFélixMartinsSantana*DepartmentofObstetrics,PaulistaSchoolofMedicine,FederalUniversityofSãoPaulo(EPM-UNIFESP),BrazilDepartmentofPerinatology,AlbertEinsteinHospital,BrazilVivianMeloCorrêaDepartmentofObstetrics,PaulistaSchoolofMedicine,FederalUniversityofSãoPaulo(EPM-UNIFESP),BrazilIsabelaBotturaDepartmentofPerinatology,AlbertEinsteinHospital,BrazilJoséPedroPariseFilhoDepartmentofPerinatology,AlbertEinsteinHospital,Brazil*Addressallcorrespondenceto:[email protected]:10.5772/intechopen.80092FromtheEditedVolumeIntechOpenMultiplePregnancyNewChallengesEditedbyJulioElitoJr.MultiplePregnancy-NewChallengesEditedbyJulioElitoJr.Show+1.IntroductionItisknownthatmultiplepregnancypresentsmorbidityandmortalityratesabout3–7timesgreaterthansinglepregnancies,andtheseareoftendeterminedindeliverycare[1].Amongthedifficultiesintwinbirth,wehighlight:prematurity,non-cephalicpresentations,dystocia,funicularprolapse,placentalabruption,increasedoperativeincidence,po

For MCDA twin pregnancies (1) between 32 weeks and 38 weeks; (2) between 1500 and 4000 grams and (3) twin A is in cephalic presentation, planned ...COVID-19AlertsOB2TUSAtlasTheGenomeGYNGYNSexualHealthPrimaryCareYourPracticeGrandRoundsMyBookshelfNow@ObGMediaAboutUsContactUsLoginObGFirstTogglenavigationCOVID-19AlertsOB2TUSAtlasTheGenomeGYNGYNSexualHealthPrimaryCareYourPracticeGrandRoundsMyBookshelfNow@ObGMediaGrandRoundsTwinBirthStudy:IsThereanOptimalDeliveryMethodforMonochorionic-DiamnioticTwins?BACKGROUNDANDPURPOSE:Studiesinvestigatingtheoptimalmodeofdeliveryformonochorionic-diamniotictwinsaremostlysmall,retrospective,observationalstudiesAvirametal.(AJOG,2020)comparedperinatalandmaternaloutcomesofplannedcesareandeliveryandplannedvaginaldeliveryofmonochorionic-diamniotictwinsusingtheTwinBirthStudydataMETHODS:SecondaryanalysisoftheTwinBirthStudyTwinBirthStudy:RCTthatincludeddichorionic-diamniotic(DCDA)andmonochorionic-diamniotic(MCDA)twinsfrom32w0dto38w6dParticipantdatausedforthissecondaryanalysisMCDAtwinpregnancies|TwinAwasincephalicpresentation|Eachtwinhadanestimatedweightbetween1500and4000gramsInterventionPlannedcesareanPlannedvaginaldeliveryStudydesignElectivedeliveryplannedbetween37weeksand5to7daysofgestationand38weeksand6to7daysofgestationComparisonsinmaternalandperinataloutcomesweremadebetweenThetwointerventiongroupsMCDAandDCDAtwinpregnanciesRESULTS:CurrentsecondarystudyPlannedcesarean:346womenPlannedvaginaldelivery:324womenRateofcesareandeliveryPlannedvaginaldelivery:39.2%Plannedcesareandelivery:91.3%Therewasnosignificantdifferenceingestationalageatdeliverybetweenthegroups(P=0.78)Vaginal:34.4weeksCesarean:34.5weeksTherewasnodifferenceinmaternaloutcomesbetweenthetwointerventiongroupsTherateofadverseneonatalcompositeoutcomesintwinsAortwinsBwassimilarinbothinterventiongroupsTwinsA:1.2%vs1.2%(P=0.92)TwinsB:1.2%vs3.2%(P=0.09)Intheplannedcesareangroup,therateofadverseneonatalcompositeoutcomewashigherintwinsBthantwinsA(P=0.03)TwinsA:1.2%TwinsB:3.2%WhencomparingMCDApr

Monochorionic diamniotic (MCDA) twin pregnancies are at increased risk of preeclampsia (PET), intrauterine growth restriction (IUGR) and intrauterine fetal ...ACOG.orgACOGClinicalGreenJournalForPatientsStoreACOG.orgACOGClinicalGreenJournalForParentsStoreMay2018-Volume131-IssuePreviousAbstractNextAbstractFullTextAccessforSubscribers:IndividualSubscribersLoginforaccessACOGMembers,pleaseclick“Loginhere”toaccesscontentLoginhere>InstitutionalMembersAccessonOvid®NotaSubscriber?BuySubscribeRequestPermissionsBecomeaSocietyMemberYoucanreadthefulltextofthisarticleifyou:SelectanoptionLogInBuyArticleSubscribeSocietyMembershipContent&PermissionsOvidMemberInstitutionalAccessLogInOvidMemberInstitutionalAccessExportAllImagestoPowerPointFileAddtoMyFavoritesColleague'sE-mailisInvalidYourName:(optional)YourEmail:Colleague'sEmail:Separatemultiplee-mailswitha(;).Message:Thoughtyoumightappreciatethisitem(s)IsawatObstetrics&Gynecology.SendacopytoyouremailYourmessagehasbeensuccessfullysenttoyourcolleague.Someerrorhasoccurredwhileprocessingyourrequest.Pleasetryaftersometime.EndNoteProciteReferenceManagerSavemyselectionSunday,April29,2018Walker,AllisonR.BS;Caughey,AaronB.MD,PhDAuthorInformationOregonHealth&ScienceUniversity,Portland,ORFinancialDisclosure:AaronCaugheydisclosedthefollowing—Celmatix:Consultant/AdvisoryBoard,OwnershipInterest;Mindchild:Consultant/AdvisoryBoard,OwnershipInterest.Theotherauthordidnotreportanypotentialconflictsofinterest.Obstetrics&Gynecology:May2018-Volume131-Issue-p168Sdoi:10.1097/01.AOG.0000533156.62632.e8BuyMetricsAbstractINTRODUCTION: Monochorionicdiamniotic(MCDA)twinpregnanciesareatincreasedriskofpreeclampsia(PET),intrauterinegrowthrestriction(IUGR)andintrauterinefetaldemise(IUFD).Ourstudycomparedoutcomesofinductionoflabor(IOL)at34through37weekstodeterminethemostfavorablegestationalagefordeliveryinMCDAtwinpregnanciescomplicatedbymildPET.METHODS: AdecisionanalyticmodelwascreatedusingTreeAgePro2017softwaretocomparetheoutcomesofexpectantmanagementversusIOLat34to

Conclusion: Vaginal delivery appears to be a good management option in uneventful monochorionic diamniotic twin pregnancies after 34 weeks' gestation.Clipboard,SearchHistory,andseveralotheradvancedfeaturesaretemporarilyunavailable.SkiptomainpagecontentCOVID-19InformationPublichealthinformation(CDC)Researchinformation(NIH)SARS-CoV-2data(NCBI)Preventionandtreatmentinformation(HHS)Español AccesskeysNCBIHomepageMyNCBIHomepageMainContentMainNavigationSearch:SearchAdvancedClipboardUserGuideSaveEmailSendtoClipboardMyBibliographyCollectionsCitationmanagerDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSavecitationtofileFormat:Summary(text)PubMedPMIDAbstract(text)CSVCreatefileCancelEmailcitationSubject:1selecteditem:23447913-PubMedTo:Format:SummarySummary(text)AbstractAbstract(text)MeSHandotherdataSendemailCancelAddtoCollectionsCreateanewcollectionAddtoanexistingcollectionNameyourcollection:Namemustbelessthan100charactersChooseacollection:UnabletoloadyourcollectionduetoanerrorPleasetryagainAddCancelAddtoMyBibliographyMyBibliographyUnabletoloadyourdelegatesduetoanerrorPleasetryagainAddCancelYoursavedsearchNameofsavedsearch:Searchterms:TestsearchtermsWouldyoulikeemailupdatesofnewsearchresults?SavedSearchAlertRadioButtonsYesNoEmail:(change)Frequency:MonthlyWeeklyDailyWhichday?ThefirstSundayThefirstMondayThefirstTuesdayThefirstWednesdayThefirstThursdayThefirstFridayThefirstSaturdayThefirstdayThefirstweekdayWhichday?SundayMondayTuesdayWednesdayThursdayFridaySaturdayReportformat:SummarySummary(text)AbstractAbstract(text)PubMedSendatmost:1item5items10items20items50items100items200itemsSendevenwhentherearen'tanynewresultsOptionaltextinemail:SaveCancelCreateafileforexternalcitationmanagementsoftwareCreatefileCancelYourRSSFeedNameofRSSFeed:Numberofitemsdisplayed:510152050100CreateRSSCancelRSSLinkCopyActionsCiteFavoritesDisplayoptionsDisplayoptionsFormatAbstractPubMedPMIDSharePermalinkCopyPagenavigationTitle&authorsAbstractSimilararticlesCitedbyPublicationtypesMeSHtermsRelatedinfor

SkiptoMainContentCookiesdisabledToolsBrowsesampleissueGetContentalertsSubscribetothisjournalCookiesaredisabledforthisbrowser.WileyOnlineLibraryrequirescookiesforauthenticationanduseofothersitefeatures;therefore,cookiesmustbeenabledtobrowsethesite.DetailedinformationonhowWileyusescookiescanbefoundinourPrivacyPolicy.JournallistmenuJournalArticlesActionsToolsFollowjournalNavigationBarMenuHomeHomeBrowseAcceptedArticlesEarlyViewCurrentIssueAllIssuesFollowjournalAlertTwitterchannelFacebookpageRSSchannelLogintoWileyOnlineLibraryEmailorCustomerIDPasswordForgotpassword?NEWUSER>INSTITUTIONALLOGIN>ChangePasswordOldPasswordNewPasswordTooShortWeakMediumStrongVeryStrongTooLongPasswordChangedSuccessfullyYourpasswordhasbeenchangedCreateanewaccountEmailorCustomerIDReturninguserForgotyourpassword?Enteryouremailaddressbelow.EmailorCustomerIDPleasecheckyouremailforinstructionsonresettingyourpassword.Ifyoudonotreceiveanemailwithin10minutes,youremailaddressmaynotberegistered,andyoumayneedtocreateanewWileyOnlineLibraryaccount.RequestUsernameCan'tsignin?Forgotyourusername?EnteryouremailaddressbelowandwewillsendyouyourusernameEmailorCustomerIDCloseIftheaddressmatchesanexistingaccountyouwillreceiveanemailwithinstructionstoretrieveyourusername

ACOG.orgACOGClinicalGreenJournalForPatientsStoreACOG.orgACOGClinicalGreenJournalForParentsStoreMay2018-Volume131-IssuePreviousAbstractNextAbstractFullTextAccessforSubscribers:IndividualSubscribersLoginforaccessACOGMembers,pleaseclick“Loginhere”toaccesscontentLoginhere>InstitutionalMembersAccessonOvid®NotaSubscriber?BuySubscribeRequestPermissionsBecomeaSocietyMemberYoucanreadthefulltextofthisarticleifyou:SelectanoptionLogInBuyArticleSubscribeSocietyMembershipContent&PermissionsOvidMemberInstitutionalAccessLogInOvidMemberInstitutionalAccessExportAllImagestoPowerPointFileAddtoMyFavoritesColleague'sE-mailisInvalidYourName:(optional)YourEmail:Colleague'sEmail:Separatemultiplee-mailswitha(;).Message:Thoughtyoumightappreciatethisitem(s)IsawatObstetrics&Gynecology.SendacopytoyouremailYourmessagehasbeensuccessfullysenttoyourcolleague.Someerrorhasoccurredwhileprocessingyourrequest.Pleasetryaftersometime.EndNoteProciteReferenceManagerSavemyselectionSunday,April29,2018Walker,AllisonR.BS;Caughey,AaronB.MD,PhDAuthorInformationOregonHealth&ScienceUniversity,Portland,ORFinancialDisclosure:AaronCaugheydisclosedthefollowing—Celmatix:Consultant/AdvisoryBoard,OwnershipInterest;Mindchild:Consultant/AdvisoryBoard,OwnershipInterest.Theotherauthordidnotreportanypotentialconflictsofinterest.Obstetrics&Gynecology:May2018-Volume131-Issue-p176Sdoi:10.1097/01.AOG.0000533186.00682.7aBuyMetricsAbstractINTRODUCTION: Dichorionicdiamniotic(DCDA)twinpregnanciesareatincreasedriskofpreeclampsia(PET),intrauterinegrowthrestriction(IUGR)andintrauterinefetaldemise(IUFD).Ourstudycomparedoutcomesofinductionoflabor(IOL)at34through37weekstodeterminethemostfavorablegestationalagefordeliveryinDCDAtwinpregnanciescomplicatedbymildPET.METHODS: AdecisionanalyticmodelwascreatedusingTreeAgePro2017softwaretocomparetheoutcomesofexpectantmanagementversusIOLat34to37weeksofgestationalage.Outcomesexaminedincludedqualityadjustedlifeyears(QALYs),casesofadvancementfrommildtoseverePET,maternalmortality,maternalstroke,IUGR,IUFD,

Among those who attempted trial of labour, the majority delivered both twins vaginally (77%). In 20% a caesarean section was performed during ...SkiptoMainContentCookiesdisabledToolsBrowsesampleissueGetContentalertsSubscribetothisjournalCookiesaredisabledforthisbrowser.WileyOnlineLibraryrequirescookiesforauthenticationanduseofothersitefeatures;therefore,cookiesmustbeenabledtobrowsethesite.DetailedinformationonhowWileyusescookiescanbefoundinourPrivacyPolicy.JournallistmenuJournalArticlesActionsToolsFollowjournalNavigationBarMenuHomeHomeBrowseAcceptedArticlesEarlyViewCurrentIssueAllIssuesFollowjournalAlertTwitterchannelFacebookpageRSSchannelLogintoWileyOnlineLibraryEmailorCustomerIDPasswordForgotpassword?NEWUSER>INSTITUTIONALLOGIN>ChangePasswordOldPasswordNewPasswordTooShortWeakMediumStrongVeryStrongTooLongPasswordChangedSuccessfullyYourpasswordhasbeenchangedCreateanewaccountEmailorCustomerIDReturninguserForgotyourpassword?Enteryouremailaddressbelow.EmailorCustomerIDPleasecheckyouremailforinstructionsonresettingyourpassword.Ifyoudonotreceiveanemailwithin10minutes,youremailaddressmaynotberegistered,andyoumayneedtocreateanewWileyOnlineLibraryaccount.RequestUsernameCan'tsignin?Forgotyourusername?EnteryouremailaddressbelowandwewillsendyouyourusernameEmailorCustomerIDCloseIftheaddressmatchesanexistingaccountyouwillreceiveanemailwithinstructionstoretrieveyourusername